Cord blood banking and transplant in Europe

Cord blood banks have increased the use of cord blood transplants (CBT) for patients with hematological disorders. EUROCORD has established a registry for providing information on the outcome of CBT. Questionnaires were sent to all EUROCORD members to collect information on patients transplanted from 1988 to 1996, One hundred and forty-three CBT, performed in 45 centers, were analyzed for survival, engraftment and graft-versus-host disease (GVHD). Results in recipients of related and unrelated transplants were analyzed separately, In 78 patients who received CB from a related donor, 1-year survival was 63 +/- 6%. Age, weight, HLA identity and negative cytomegalovirus (CMV) scrology in the recipient were significant favorable prognostic factors. Among these 78 patients, the incidence of grade greater than or equal to II GVHD was 9% in HLA matched CBT and 50% in mismatched CBT. Neutrophil engraftment was associated with age <6 years (P = 0.02), weight <20 kg (P = 0.02), It was 73% in patients receiving <3.7 x 10(7) nucleated cells (NC) infused/kg and 85% in patients receiving more (P = 0.06), Among 65 patients, who received CB from an unrelated donor, I-year survival was 29 +/- 7%. Negative recipient CMV serology was associated with improved survival (P = 0.01). Acute GVHD greater than or equal to II was observed in 40% of these patients, Negative recipient CMV serology was the most important factor for predicting GVHD (P = 0.04). Neutrophil recovery was 76% in patients receiving <3.7 x 10(7) NC/kg and 94% in patients receiving more (P = 0.008). Cord blood is a feasible alternative source of hematopoietic stem cells for treating patients with various hematological disorders.